Morning cortisol levels and quality of social interactions across the transition to school predict the development of children’s anxious and depressive symptoms in first grade

Previous studies spanning the transition from preschool to school (kindergarten) revealed individual differences in children's stress response, measured by cortisol concentrations. However, whether these represented adaptive cortisol concentration patterns or a risk factor for maladaptation remained unclear because very few studies examined functional correlates of cortisol changes, such as anxious or depressive symptoms. Furthermore, prior research has suggested that social interactions may play a significant role in this association since sensitive stress responses patterns might interact with unsupportive interactions to predict the development of mental health symptoms. For the current study, the pattern of morning cortisol concentration in children was described over 6 time-points before, during and after kindergarten entry. The first objective was to examine the associations between this pattern and the development of anxious or depressive symptoms 18 months later (first grade). The second objective was to examine whether children's quality of social interactions (i.e., family relational health or peer problems) interacted with these same patterns to predict anxious and depressive symptoms. For this longitudinal study, children and their parents (N = 379) were recruited from the 3D pregnancy study and followed from preschool to first grade. Piecewise latent growth curve models showed that while morning cortisol concentrations increased at a similar rate for all children over the first two weeks of school, children differed from one another in their levels at school entry. During the post-entry period, morning cortisol concentrations showed a U-shaped curve: a decrease during the first two months followed by an increase for the next three to five months. Main and moderation effects suggest that a hypoactivation of the stress response system (i.e., low cortisol levels at school entry or steeper post-entry decrease) during the school transition may be a risk factor for maladaptation in children as it was associated with later increasing anxious and depressive symptoms, especially under specific social environmental conditions. Children exhibiting such hypoactive cortisol patterns appear to be more vulnerable to lower-quality social environment, whether with family or peers, supporting the diathesis-stress model. Results also highlight the potentially protective function of high-quality social interactions in the development of anxious and depressive symptoms for those with hypoactive stress response system.